Comparison on outcomes of pharmaco-invasive strategy, delayed routine percutaneous coronary intervention (PCI) and optimal medical therapy (OMT) after successful thrombolysis in patients with ST elevation myocardial infarction (STEMI): 1 Year data from a single centre

2021 ◽  
Vol 345 ◽  
pp. 16-17
Author(s):  
Y.F. Kwan ◽  
W.S. Tham ◽  
G.Y. Lim ◽  
K.C. Wong ◽  
R. Sathappan ◽  
...  
2012 ◽  
Vol 7 (2) ◽  
pp. 81
Author(s):  
Bruce R Brodie ◽  

This article reviews optimum therapies for the management of ST-elevation myocardial infarction (STEMI) with primary percutaneous coronary intervention (PCI). Optimum anti-thrombotic therapy includes aspirin, bivalirudin and the new anti-platelet agents prasugrel or ticagrelor. Stent thrombosis (ST) has been a major concern but can be reduced by achieving optimal stent deployment, use of prasugrel or ticagrelor, selective use of drug-eluting stents (DES) and use of new generation DES. Large thrombus burden is often associated poor outcomes. Patients with moderate to large thrombus should be managed with aspiration thrombectomy and patients with giant thrombus should be treated with glycoprotein IIb/IIIa inhibitors and may require rheolytic thrombectomy. The great majority of STEMI patients presenting at non-PCI hospitals can best be managed with transfer for primary PCI even with substantial delays. A small group of patients who present very early, who are at high clinical risk and have long delays to PCI, may best be treated with a pharmaco-invasive strategy.


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